Ben Kilbey, Spearhead Healthcare’s expert on infection control in the care environment, answers ten quick-fire questions to help care homes ramp up their resistance to infection over the winter months.
1) What are the biggest mistakes you see care homes making when it comes to cleaning procedures?
Without doubt the biggest mistake is to use standard household cleaning detergents or poor quality basic disinfectants which simply aren’t up to the job. Furniture polish falls into this category!
Secondly, it’s always a concern if proper cleaning schedules aren’t in place – meaning that vital areas or surfaces could get missed – in tandem with watertight documentation procedures.
2) How can care homes make an immediate difference to their infection control capabilities?
Rigorously enforcing good handwashing procedures is the best place to start: use antimicrobial soap and ensure hands are always dried with a disposable paper towel.
Staff should be using appropriate personal protective equipment (PPE), including gloves and aprons especially when attending to personal care, which should be changed before every task.
Ensure that the correct chemicals – and dilutions – are utilised at all times.
3) What are your longer-term recommendations?
Formulate a plan based on risk assessments, detailed infection control policies, staff training and meticulous documentation. There is plenty of external guidance available, and it needs to be done in conjunction with the local health board procedures. Areas to focus on include:
- Cleaning schedules – formulate detailed cleaning routines for staff to follow in each area of the home along with strict procedures for staff to mark them off when areas are completed
- Introduce colour-coding for cloths, mops, etc
- Review practices in chemical usage. Combine daily use of appropriate chemicals with a monthly deep clean with a sporicidal disinfectant product
- Provide COSHH (Control of Substances Hazardous to Health Regulations) training to staff, and put visual aids in place such as wall charts highlighting hazards and product usage guidance
- Regularly clean equipment such as moving and handling equipment, hoists, stand aids, wheelchairs and weighing scales (and document that you have done so).
4) What about laundry procedures?
Certainly review handling procedures for soiled laundry. Are red bags used, along with segregated laundry carts and trolleys to avoid clean laundry being contaminated? Is laundry washed at correct temperatures and with antibacterial cleaning products?
5) Any areas of the care home that often get overlooked?
Curtains. These must be washed. Bacteria and viruses can survive on fabric!
6) What are the most common myths in care home hygiene?
Bleach kills everything! This is not always the case. Its efficacy depends on its strength and if it has been tested to the BSEN1276 standard. Also, it cannot be used on all surfaces, is corrosive and can emit harmful fumes. In fact, there are numerous reasons why bleach is not suitable for care environments.
7) In care homes that are rated outstanding, how do they go the extra mile in infection control?
In our experience, outstanding care homes realise that infection control is not just for winter months but an all-year-round commitment. They have top-notch hand-washing facilities and procedures at all times, not just when gloves are being put on or taken off.
They do not skimp on vital practical equipment and they are highly systematic in their use of infection control cleaning products. Colour-coding is in place for cleaning cloths and mops.
Documentation also plays a big role. It demonstrates your commitment to best practices, instils organisation, structure and oversight. It also delivers transparency, which is crucial for effective communication – and strong relationships – with all stakeholders.
8) Do you have any advice for care homes that suffer an outbreak?
Don’t rely on your regular cleaning products. You need to use specialist sporicidal cleaning products until the virus or infection has been eradicated. The right products will kill all known pathogens and as close as possible to 100 per cent of harmful germs, viruses and spores – and they can even be used on soft furnishings.
9) Any other important considerations to mention?
Chemicals pose serious risks for residents and storage procedures must be thoroughly reviewed. They shouldn’t be left around the home and in particular, cleaning trolleys should not be left in corridors or unattended.
10) Any tips to help homes become an infection control leader as cost-effectively as possible?
Homes can ensure that suitable dispensers are available for items such as gloves and aprons to reduce wastage. Wall-mounted soap and hand towel dispensers are also valuable for the same reason. For cleaning products, diluting equipment can be used for concentrated chemicals to reduce the ‘cost-in-use’.
Read more on infection control in the Jan/Feb issue of CHM Online, online now!